Efficacy and rebound rates in propranolol‐treated subglottic hemangioma: A literature review

Schwartz, Tyler R.; Faria, John; Pawar, Sachin; Siegel, Dawn H.; Chun, Robert H.

doi:10.1002/lary.26818

Cited by 17 publications

(14 citation statements)

References 58 publications

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“…A recent review of the literature by Schwartz et al in 2017 found a success rate of 88% among 49 patients treated in this way for SGH. The remaining 12% were treated with endoscopic debulking followed by open surgery (10). The same report documented a very low grade of rebound growth after drug administration (9%), and half of children experiencing such a problem recovered after having increased the pharmacological dosage (10).…”

Section: Endoscopic Treatmentmentioning

confidence: 99%

“…The remaining 12% were treated with endoscopic debulking followed by open surgery (10). The same report documented a very low grade of rebound growth after drug administration (9%), and half of children experiencing such a problem recovered after having increased the pharmacological dosage (10). Therefore, endoscopic and/or open-neck surgical treatment of SGH should be nowadays considered as the last option and performed only after failure of appropriate conservative medical treatment.…”

Section: Endoscopic Treatmentmentioning

confidence: 99%

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Surgical treatment of primary tracheal tumors in children and adolescents

Giannini¹,

Incandela²,

Bresciani³

et al. 2019

Pediatr Med

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Pediatric primary tracheal tumors (PTTs) are rare entities, with an estimated incidence of 0.2% among all neoplasms in children and adolescents. Benign lesions and malignancies are rather equally represented, with subglottic hemangioma, granular cell tumor, carcinoid tumor, and low-grade mucoepidermoid carcinoma being the most common histotypes. Guidelines on management and treatment of pediatric PTTs are not available, and only a few reviews, case reports, and single surgeon/institute experiences have been published. A literature search was carried out focusing on the surgical approaches utilized in the most recent publications to manage pediatric PTTs, thus including case reports, single institute experiences, and reviews on surgical techniques. Moreover, we divided the available intervention modalities based on an anatomical classification, distinguishing between laryngotracheal, cervical tracheal, lower tracheal, and carinal scenarios. Endoscopic treatment is still underused, even for benign lesions: this is mainly due to the difficulties that surgeons may experience during airway management, appropriate tumor visualization, and its safe removal with adequate prevention/management of intraoperative complications.Considering open surgery, simple tumorectomy via median thyrotomy is the treatment of choice whenever possible (mainly for benign tumors), whereas in case of wider excisions, laryngotracheal resection and reconstruction with cartilage graft, end-to-end anastomosis, or neo-carinal reconstruction represent the most widely used procedures. All these techniques are similar to what described in adults. Strict cooperation with an experienced team of pediatric anesthesiologists and intensivists is of paramount importance for the adequate management of PTTs in young children. We are far from establishing a common guideline for treatment of PTTs. Mini-invasive procedures should be encouraged and developed since the majority of pediatric histotypes are benign or low-grade cancers. Moreover, patients should be addressed to specialized pediatric centers in order to improve and refine the existing techniques, laying the groundwork for the proposal of new procedures.

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Section: Endoscopic Treatmentmentioning

confidence: 99%

Section: Endoscopic Treatmentmentioning

confidence: 99%

Surgical treatment of primary tracheal tumors in children and adolescents

Giannini¹,

Incandela²,

Bresciani³

et al. 2019

Pediatr Med

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show abstract

“…Bei Erwachsenen wird typischerweise die hintere Glottis befallen, bei Kindern die vordere und die subglottische Region [35]. Makroskopisch handelt es sich um kleine (typischerweise < 2 cm große), gelblich-weiße, submuköse, abgegrenzte Gewebevermehrungen mit ödematös-hämorrhagischem Randsaum [34] [41,42]. Von anderen wird eine CO 2 -Lasertherapie als sehr erfolgversprechendes Therapiekonzept angesehen [43].…”

Section: Granularzelltumor (Gzt)unclassified

“…Das weibliche Geschlecht ist bevorzugt[42]. Ohne Therapie kommt es zur Atemwegsobstruktion und Mortalitätsraten um bis zu 50 %, wenn bei Kleinkindern die engste Stelle des Atemweges, d. h. die Subglottis betroffen ist[41,43]. Symptome sind Atemanstrengung, Stridor, Husten, Zyanose mit deutlichen Sauerstoffentsättigungen[42].…”

unclassified

Subglottische Pathologien

Heyduck

Pickhard²,

Brosch

et al. 2019

Laryngo-Rhino-Otol

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ZusammenfassungSubglottische Pathologien sind sehr selten und manifestieren sich mit einem unspezifischen klinischen Erscheinungsbild in Form einer Gewebevermehrung auf Höhe des Ringknorpels bzw. der cranialen Trachea, was die Diagnose verschleiert. Typische Symptome solcher Patienten sind Heiserkeit, Reizhusten, ein Fremdkörpergefühl sowie Dyspnoe bzw. Stridor. Differenzialdiagnostisch kommen verschiedene Erkrankungen in Frage: Benigne Erkrankungen wie Folgen eines Traumas (z. B. Stenosen), Entzündungen (z. B. Pseudokrupp), rheumatische Erkrankungen (z. B. Granulomatose mit Polyangiitis) oder gutartige Tumore (z. B. Papillom, Hämangiom oder Granularzelltumor). Auch maligne Erkrankungen wie z. B. ein Plattenepithelkarzinom des Larynx, ein Chondrosarkom oder sehr selten eine laryngeale Lymphommanifestation müssen differenzialdiagnostisch in Erwägung gezogen werden. Idiopathische Formen ohne erkennbare Ursache sind ebenfalls denkbar. Zur Diagnosesicherung wird bei tumorösen Veränderungen in der Regel eine Probeexzision mit histologischer Aufarbeitung durchgeführt. Die Therapie erfolgt in Abhängigkeit vom histologischen Ergebnis – bei soliden tumorösen Erkrankungen üblicherweise chirurgisch oder durch eine Lokal- bzw. Systemtherapie im interdisziplinären Kontext.

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“…The effectiveness of propranolol on cutaneous infantile haemangioma was first described by Léauté-Labrèze et al in 2008 4. Since then, the use of propranolol for the treatment of subglottic haemangioma has become hugely popular due to ‘its effectiveness and safety profile as compared with more traditional methods of treatment such as systematic and intralesional steroids, vincristine, bleomycin or interferon’ 5. ‘Laser and surgical excision are now reserved for unresponsive for acutely life-threatening haemangiomas’ 5.…”

Section: Introductionmentioning

confidence: 99%

Treatment failure with propranolol for subglottic haemangioma

Liu¹,

Yeo

Jackson

et al. 2019

BMJ Case Rep

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The use of propranolol for the treatment of subglottic haemangioma has become hugely popular due to its effectiveness and safety profile. We report a case of 7-month-old boy who presented with stridor and histopathology suggestive of subglottic haemangioma following microlaryngoscopy and bronchoscopy (MLB). However, he did not respond to propranolol treatment. This could be due to an older age of propranolol commencement. In general, early commencement of propranolol is necessary when diagnosis of symptomatic infantile haemangioma is made to achieve maximal improvement in symptoms and prevent further proliferation. There should be a high index of suspicion for subglottic haemangioma in children presenting with chronic biphasic stridor, with early MLB and diagnosis. This will allow early treatment, giving the best chance to avoid our situation.

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Efficacy and rebound rates in propranolol‐treated subglottic hemangioma: A literature review

Cited by 17 publications

References 58 publications

Surgical treatment of primary tracheal tumors in children and adolescents

Surgical treatment of primary tracheal tumors in children and adolescents

Subglottische Pathologien

Treatment failure with propranolol for subglottic haemangioma

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